Pituitary News, Issue 13 - Autumn 1999.

An interesting editorial appeared in the British Medical Journal on 4th September 1999 and our Chairman, Professor Stafford Lightman, summarises this here:

This editorial in the September 4th issue of the British Medical Journal takes a critical look at the surgical treatment of patients with Growth hormone secreting pituitary adenomas. The objective of treatment is to alleviate both the symptoms and the medical consequences of Acromegaly. This is achieved if the level of growth hormone can be reduced to less than 5mU/l. In good neurosurgical centres these levels of growth hormone are achieved after surgery in about 80% of patients with small adenomas (less than 1 centimetre) but only 60% of patients with large tumours. The editorial clearly points out that surgical success is closely related to the experience of the individual neurosurgeon, and that in centres where no single neurosurgeon specialises in pituitary surgery, success rates can fall as low as 20%. The editorial recommends that endocrinologists have a responsibility to choose the 'best' surgeon for their patients even if this means referring outside their own local area. Pressure needs to be exerted on neurosurgeons for fewer centres to perform pituitary surgery and for fewer but more specialist neurosurgeons to do the work.

A full copy of the editorial can be accessed online from the British Medical Journal web site.